Real-World Effectiveness and Safety of Deucravacitinib for Plaque Psoriasis: A Multicenter Study in Korea

Background: Deucravacinib, an oral tyrosine kinase 2 inhibitor, has demonstrated efficacy and safety in clinical trials; however, real-world evidence remains limited. Objective: To evaluate real-world effectiveness, safety, and treatment persistence of deucravacinib in Korean patients with plaque psoriasis. Methods: This retrospective multicenter study included adults with plaque psoriasis treated with deucravacinib at 3 tertiary hospitals. Efficacy was assessed using Psoriasis Area and Severity Index (PASI), body surface area, and Psoriasis Scalp Severity Index at baseline, 4–6, 10–12, and ≥13 months. PASI75 and PASI90 responses were analyzed using observed case (OC) and modified non-responder imputation (mNRI). Adverse events (AEs) and persistence were analyzed descriptively. Univariable and multivariable logistic regression analyses were performed to identify predictors of efficacy and AEs. Results: Forty-two patients (baseline PASI: 12.18±4.01) were included. PASI score decreased significantly to 3.42±3.10 at 4–6 months and 1.72±2.29 at 10–12 months. At 10–12 months, PASI75 and PASI90 response rates were 90.0% and 70.0% (OC; 18/20 and 14/20), and 75.0% and 58.3% (mNRI; 18/24 and 14/24). Thirteen patients (31.0%) reported AEs, primarily mucocutaneous and infectious; 3 patients discontinued deucravacinib due to AEs. In both univariable and exploratory multivariable analyses, prior antihistamine use showed consistent borderline trends for PASI75 response, while male sex, increasing age, and shorter psoriasis duration showed borderline trends in either model. Treatment persistence was 73.2% at the last follow-up. Conclusion: Deucravacinib demonstrated consistent effectiveness, acceptable safety, and favorable persistence in routine Korean clinical practice, supporting its role as an oral treatment option for psoriasis.